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General NPI Number Information
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NPI Number | 1043244239
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Entity Type | Organization
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Legal Business Name | DAWN M GROTEN MD IN
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 1118 AUSTIN WAY
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City | NAPA
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State | CA
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Zip | 94558-4225
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Country | US
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Telephone | 707-253-2653
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Fax | 707-253-1297
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Provider Business Mailing Address
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Address Line | 3212 JEFFERSON ST #196
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City | NAPA
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State | CA
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Zip | 94558-3436
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Country | US
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Telephone | 707-255-8825
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Fax | 707-252-9325
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAWN M GROTEN
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Credential | MD
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Telephone | 707-255-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | G54516
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License Number State | CA
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